Pocket Reduction Surgery

Pocket reduction surgery (also known as gingivectomy, osseous surgery and flap surgery) is a collective term for a series of several different surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus).

The human mouth contains dozens of different bacteria at any given time.  The bacteria found in plaque (the sticky substance on teeth) produce acids that lead to demineralization of the tooth surface, and ultimately contribute to periodontal disease.

Periodontal infections cause a chronic inflammatory response in the body that literally destroys bone and gum tissues once they invade the subgingival area (below the gum line).  Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed.

Periodontal disease is a progressive condition which, if left untreated, causes massive bacteria colonization in gum pockets can eventually lead to teeth falling out.  Pocket reduction surgery is an attempt to alleviate this destructive cycle, and reduce the depth of the bacteria-harboring pockets.

Reasons for the pocket reduction surgery

Pocket reduction surgery is a common periodontal procedure which has been proven effective at eliminating bacteria, reducing inflammation and saving teeth.  The goals of pocket reduction surgery are:

  • Reducing bacterial spread – Oral bacteria has been connected to many other serious conditions such as diabetes, heart disease and stroke.  Oral bacteria can travel to various parts of the body from inside the bloodstream and begin to colonize.  It is important to decrease bacteria in the mouth in order to reduce the risk of secondary infection.

  • Halting bone loss – The chronic inflammatory response induced by oral bacteria leads the body to destroy bone tissue.  As the jawbone becomes affected by periodontal disease, the teeth lose their rigid anchor.  When the teeth become too loose, they may require extraction.

  • Facilitate home care – As the gum pockets become progressively deeper, they become incredibly difficult to clean by the patient.  The toothbrush and dental floss cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections.

What does pocket reduction surgery involve?

Before recommending treatment or performing any procedure, the dentist will perform thorough visual and x-ray examinations in order to assess the condition of the teeth, gums and underlying bone.  Pocket reduction surgery is always performed under local anesthetic.  IV consious sedation is recommended to make the patient more comfortable. 

The gums will be gently pulled back from the teeth to allow access around and between the teeth. Scaling and root planing will performed to remove bacteria and calculus (tartar).  This is essentially a "surgical cleaning". The final part of the surgery invloves smoothing the irregular contours of the bone that have been damaged by the inflammation, so the gums will lay flat and the pockets will be reduced. The gum is then sutured with back in place and allowed to heal.  Most patients experience only mild to moderate pain for 2-5 days.

Though the teeth and gums will be more sensitive immediately following the procedure, they will eventually return to normal. There will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums.  This will allow for improved access for oral hygiene efforts to keep the gums healthy for years to come.  

It is important to have regular cleanings (perio maintenance) to prevent the return of periodontal disease and to assess proper home care.

If you would like more information on Pocket Reduction Surgery in Dallas by Dr. Marshal Goldberg please email, or call 214-890-7777


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